A Practitioner’s Toolkit for Insulin Motivation in Adults with Type 1 and Type 2 Diabetes Mellitus: Evidence-Based Recommendations from an International Expert Panel

Abstract

Aim: To develop an evidence-based expert group opinion on the role of insulin motivation to overcome insulin distress during different stages of insulin therapy and to propose a practitioner's toolkit for insulin motivation in the management of diabetes mellitus (DM). Background: Insulin distress, an emotional response of the patient to the suggested use of insulin, acts as a major barrier to insulin therapy in the management of DM. Addressing patient-, physician-and drug-related factors is important to overcome insulin distress. Strengthening of communication between physicians and patients with diabetes and enhancing the patients' coping skills are prerequisites to create a sense of comfort with the use of insulin. Insulin motivation is key to achieving targeted goals in diabetes care. A group of

Insulin under the influence of light

“…Patients' understanding of the importance and rationale of insulin therapy should also be improved, so that they can monitor their blood glucose better and self-manage their diabetes more effectively [102]. Another problem is patient non-compliance due to psychological factors such as insulin distress (apprehension and dejection due to a perceived inability to cope with the requirements of insulin therapy [103]), which causes significant lack of motivation [104]. There remains a need for clinicians to use tools such as counselling and motivational interviewing to collaborate with and empower their patients and to improve noncompliance [103].…”

“…Another problem is patient non-compliance due to psychological factors such as insulin distress (apprehension and dejection due to a perceived inability to cope with the requirements of insulin therapy [103]), which causes significant lack of motivation [104]. There remains a need for clinicians to use tools such as counselling and motivational interviewing to collaborate with and empower their patients and to improve noncompliance [103]. Indeed, a study of 116 T2DM patients who were initially non-adherent to therapy found that after one month of counselling, 90% of them began adhering to treatment [105].…”

Expert Opinion: A Call for Basal Insulin Titration in Patients with Type 2 Diabetes in Daily Practice: Southeast European Perspective

“…There are expert recommendations [16,18] on insulin initiation and titration, including basal insulin initial dose, fasting plasma glucose (FPG) target range, dose adjustment algorithms, optimal insulin dose at the end of the titration process, use of other antihyperglycaemic drugs after initiating basal insulin, managing insulin distress, performing motivational interviews, or conversing with patients about insulin initiation after a diabetes diagnosis.…”

Insulinization in T2DM with Basal Analogues During COVID-19 Pandemic: Expert Opinion from an Indian Panel

“…Continuing to follow lifestyle modifications needs to be stressed upon by the clinicians during and after the pandemic. Despite its efficacy in achieving glycemic control, the initiation of insulin therapy is often delayed in people with T2DM in India [ 5 ]. It is anticipated that delaying insulin initiation is even more common during the COVID-19 pandemic because of the presence of overarching concerns during these times which include [ 6 ]: Restricted movement Reduced access to healthcare resources including medications and glucose test strips Missed follow-ups including laboratory tests and visits to healthcare providers Restricted time for interaction leading to lack of counselling and training Challenges with remote monitoring of blood glucose levels Lack of adequate troubleshooting including correction of injection technique and proper use of insulin devices …”